Some of you who have been around this blog for a while will be aware that I’m a medical doctor and that I work in the National Health Service in Scotland at the Glasgow Homeopathic Hospital. I blog with a hope that my photos and my writings might add a little to the lives of people who browse here. I want to make a contribution. I want my contribution to the intricate net of connections between us to be one of positivity, something which you might find life-enhancing, or inspiring, or thought-provoking, or interesting, or moving.
You know what I hate? Negativity and cynicism. There are people who like to pour their energies into tearing things down. I’m not one of them. I don’t know what you’d think constitutes a good life, but for me, it’s something to do with being the hero of your own story, not a zombie in somebody else’s. What do I mean by that? Well, you can read more about these ideas on the permanent pages (see the tabs, Hero or zombie?, and AdaptCreateEngage, above the banner photo at the top of the blog).
There is a concerted campaign to drive homeopathy out of the National Health Service. This is a campaign to tear something down. I had a brush with it today and the experience has provoked me to write down my views about this therapy which I practice – to explain it a bit.
I wrote a post about homeopathy once before, but what I’ve done now is copy that text into a new permanent page entitled “Homeopathy“. You’ll find that first post under the heading “Part One”. Then I’ve added my thoughts on some of the points which are raised in this debate. You’ll find them under the heading “Part Two”.
These two parts make for an article that’s way too long for a post and I hope there are some points in there which will make a positive contribution.
Heroes Not Zombies 
bob, firstly, you do your readers (and i imagine numerous others) a great service by taking the time and putting forth the effort to share your knowledge, your views, and perhaps more than anything, your optimism and enthusiasm.
i’ve read your writing on homeopathy, and it makes tremendous sense. i’m very supportive of the concepts and the progress amazes me. i think of all your points regarding any resistance, money is probably the dominating factor. the drug industry has become the ultimate hungry animal. i’m not sure how things are there, but here in the u.s., it’s one of the major factors swaying effective, fair, and reasonable health care. it’s a social issue, a political issue — hell it’s beyond issues, it’s the entire subscription.
please don’t be discouraged. the world would be lost without your interests and impact. as you know, most progress is slow and often initially resisted.
take care.
If a multinational pharmaceutical company produced a new drug which, in clinical trials, worked no better than a placebo, but for which the company produced lots of anecdotal evidence from patients, should that drug be licensed for sale?
Thankyou for that support and those very encouraging comments damewiggy. Such positive feedback makes blogging worth while.
Andysnat, it might surprise you to know that the answer is not a simple yes or no. You might be familiar with the MHRA site – the body which has the responsibility for making such decisions in the UK. Here’s what questions they ask to ensure they make good decisions –
Does the product work and offer useful clinical benefit if used in its specified way?
Is there robust evidence that the product will do what the company says it will do?
What impact will the product have, or is it having, on both the quality and length of life in those patients who are treated with it or on whose behalf it is used?
Has the manufacturer demonstrated that it can consistently and reliably make the product to the required level of quality?
Does the evidence available before a product is marketed give a clear indication of all adverse effects that have been discovered, the likelihood that they will occur and their severity?
Have companies done all they reasonably can to identify, reduce and communicate risks?
If the available evidence on safety, quality or performance is uncertain or unclear, is more needed before a decision can be made?
Is there relevant evidence about everyday use of this or similar products, or do we need to seek such evidence?
A scientifically excellent clinical trial is of limited value if its design does not reflect the likely use of the product in everyday situations
From knowledge of how the product works, is it possible to predict other adverse effects that may occur when the product is used with larger and wider groups of people, or in conjunction with other products? If so, are there clear plans in place to track and manage the risks?
Can the risk of adverse effects be limited by restricting the product’s use to specific groups of patients, or to particular dosages or durations of use?
What risks are associated with the condition the product is designed to manage?
Do the risks of not treating the condition outweigh the risks associated with the product? Is it a very serious/debilitating condition, or a mild and self-limiting one? Greater risks may be acceptable for products that markedly reduce suffering or treat life-threatening conditions, especially those for which no other effective treatment is available
Can the Agency accept less evidence on which to base its decision if the rarity of the clinical condition means that more detailed evidence cannot reasonably be gathered?
Is the Agency prepared to accept early and limited evidence on which to come to a decision if a product, while appearing to have acceptable risks, offers significant or urgent benefits to public health or outstanding benefits to patients?
Are there, or can there be, warnings for the public as well as for healthcare professionals about the nature and likelihood of adverse effects, warnings that are understandable and specific enough for them to make informed choices or to restrict the usage?
If not, how else might the risks be managed? Would it be better not to allow the product to come onto or to remain on the market, or to restrict its availability?
Does the Agency’s decision take account of the known views of the public about the balance between risks and benefits? If the public’s views are in conflict with robust and comprehensive scientific evidence, should they carry any weight?
Does the Agency need to seek further views from relevant parties?
In addition to the scientific evidence, do we need views from healthcare professionals, organisations concerned with specific conditions, and/or patients who have used the product?
Decision making is not therefore a simple yes or no based on RCTs. One of the key responsibilities of the Agency is to ensure safety so they really want to know about the potential harms of a drug. And, yes, they are also interested in the experiences of professionals and patients (which is what I presume you mean by anecdote?)
But you know what? I don’t think a pharmaceutical company, which exists to make profits for its shareholders, would see much mileage in marketing a product which they didn’t think was any better than placebo. So they probably wouldn’t ask for a licence.
I took a look at the MHRA website briefly, and found the following quote in their About Us section –
“The Medicines and Healthcare products Regulatory Agency (MHRA) is the government agency which is responsible for ensuring that medicines and medical devices work, and are acceptably safe.”
I imagine they will have no difficulty with the safety, but I couldn’t find yet where they demonstrate that homeopathic medicines work.
I’ll keep looking should I?
Hi Andy,
This is an area of controversy as the Guardian pointed out when it covered the role of the MHRA in licensing homeopathic products back in 2006. See http://www.guardian.co.uk/medicine/story/0,,1862554,00.html for their story.
The line the MHRA takes is that, as you rightly pointed out, safety is their priority and they design their systems to ensure that. What they take to answer “do homeopathic remedies do what they claim to do?” is use observational studies as you’ll see mentioned in the Guardian article. Some people aren’t happy with that, but that’s what they do!
From what the Guardian says then –
“…………observations of the symptoms (such as watering eyes or headaches) a person gets when given a particular substance………”
– this means, I think, that homoeopathy says that if something gives you a headache, then it’ll cure one as well? Am I understanding that correctly? It doesn’t seem very sensible to me.
I used to work in a local natural market years ago, and during that time I learned a lot about homeopathy and found it to be a TREMENDOUS help to my family. Come to find out, my Dad is a homeopathy fan too and has been for YEARS! (There’s a story that my brother found his kit and tried to convince my sister he was on drugs as a joke~LOL!) Anyway, I am extremely happy to find your blog and will go and check out your homeopathy post. I am ALWAYS excited to learn more on this subject! So I’ll definitely be back…. (((((HUGS))))) sandi
Andy, your question prompted me to write a new post – here it is – https://heroesnotzombies.wordpress.com/2007/11/18/changing-perspectives-paradoxes/
titus2woman, thank you for your encouragement. It’s always good to hear of people’s positive experiences and to know there are people who share the excitement of learning. I really like the header and byline of your blog – “Always a work in progress!
More people fail from a lack of encouragement than anything else!”
Dear Dr. Leckridge,
I really do feel that surely they cannot close the homeopathic hospitals because when the NHS was formed in 1948, it was enshrined in its constitution that homeopathy will always be available as long as there were patients who wanted it. I would like to call up all the homeopathic hospitals and find out what their waiting lists have been like because I am quite sure that there are definitely lots of patients who want it!! So surely it is illegal what they are doing?
I also noticed the stark contrast between the hospitals in Kent which had that outbreak of C difficile and the Tunbridge Wells homeopathic hospital. Someone should have pointed that out.
Surely it can legally be proven that the NHS in its formation, pledged to make provision for homeopathy. Surely this is set in stone??? When I contacted Dr. Fisher, he said they were exploring the legal status.
I am a homeopathic practitioner and I am passionate about promoting homeopathy having seen so many miracles for the past 20 years of using it.
Best wishes,
Louise Mclean
I’ll read it.
Thank you for taking the time to come and comment Louise. I understand your frustration but I’m really not sure about the legal angle.
Yes, it’s true that homeopathy was included in the NHS at the outset. That was partly because the way the NHS was created was by absorbing most of the existing hospitals in the UK and that included the homeopathic ones. And, yes, there was a statement made by the government of the time about continuing the availability of homoeopathy in the new NHS – I think the phrase was something like – when there are patients who want it and doctors available to provide it – something like that. In fact, it was that qualification about doctors being available that led to the Faculty of Homeopathy Act to set up a body to train and maintain standards of practice of homeopathy by doctors.
Oh, and “set in stone”? No, nothing is set in stone!
I too am passionate about what I do. I love every day of my work. To be able to help others is surely one of the greatest satisfactions in life.
Ok Andy, I hope you find it interesting
I have written on the topic of the assault on homeopathy — specifically on Richard Dawkins’ recent TV programme — on my homeopathy blog, which may interest readers of this site:
http://www.homeopathyzone.com/blog/article/is-homeopathic-medicine-the-enemy-of-reason
I also encounter a lot of extremely biased criticism of homeopathy based on shoddy reading of the evidence. E.g. I challenged Ben Golacre, the Guardian ‘Bad Science’ columnist and as such an influential player in the anti-homeopathy backlash in the UK, to explain his misrepresentation of data in a letter he published in The Lancet which he reproduced in his blog. He quickly bowed out of the discussion once he realized he couldn’t defend his position, and others that entered the debate likewise failed to address the points I’d made. The thread is found at:
.www.badscience.net/2007/11/the-lancet-benefits-and-risks-of-homoeopathy
I believe that the only way to not lose politically against mainstream medicine is to push for consumer-choice centered health-care, as is happening in some States in the US. This will remove medicine from the realm of science in its too narrow sence to the realm of craft. Presumably the better craft will produce better clinical results.
Here is a blog with a link to a facility, actually a Hospital in the USA that has been doing research on homeopathy.
I have not been able to post the direct link to specific studies as the website just will not let me but if you go here and look for Homeopathy and start clicking around eventually you will come to a number of studies done on specific homeopathic remedies.
http://www.healthsalon.org/187/homeopathic-studies-a-resource/